scholarly journals The Impact of the Major Histocompatibility Complex Class I-Related Chain a (Mica) and Human Leukocyte Antigen (HLA)-DP Mismatches on Severe Acute GVHD in Patients Receiving Allogeneic Hematopoietic Progenitor Cell Transplants (AHPCT) from Adult Unrelated Donors

2012 ◽  
Vol 18 (2) ◽  
pp. S223
Author(s):  
M. Askar ◽  
L. Rybicki ◽  
A. Zhang ◽  
D. Thomas ◽  
M. Kalaycio ◽  
...  
Keyword(s):  
Progenitor Cell ◽  
Acute Gvhd ◽  
Human Leukocyte ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Leukocyte Antigen ◽  
Histocompatibility Complex ◽  
Cell Transplants ◽  
Unrelated Donors ◽  
The Impact

HLA mismatch combinations associated with decreased risk of relapse: implications for the molecular mechanism

Blood ◽  
2009 ◽  
Vol 113 (12) ◽  
pp. 2851-2858 ◽  
Author(s):  
Takakazu Kawase ◽  
Keitaro Matsuo ◽  
Koichi Kashiwase ◽  
Hidetoshi Inoko ◽  
Hiroh Saji ◽  
...  
Keyword(s):  
Acute Gvhd ◽  
Hematologic Malignancy ◽  
Human Leukocyte ◽  
Hematologic Malignancies ◽  
Hematopoietic Stem ◽  
Clinical Issue ◽  
Leukocyte Antigen ◽  
Unrelated Donors ◽  
Risk Of Relapse ◽  
Made In

Abstract The finding that the risk of relapse in hematologic malignancy decreases after allogeneic hematopoietic stem cell transplantation (HSCT) has lead to the concept of a graft-versus-leukemia (GVL) effect. However, this beneficial effect is considered to be frequently offset by graft-versus-host disease (GVHD). Thus, improving HSCT outcomes by separating GVL from GVHD is a key clinical issue. This cohort study registered 4643 patients with hematologic malignancies who received transplants from unrelated donors. Six major human leukocyte antigen (HLA) loci were retrospectively genotyped. We identified 4 HLA-Cw and 6 HLA-DPB1 mismatch combinations responsible for a decreased risk of relapse; of these, 8 of 10 combinations were different from those responsible for severe acute GVHD, including all 6 of the HLA-DPB1 combinations. Pairs with these combinations of HLA-DPB1 were associated with a significantly better overall survival than were completely matched pairs. Moreover, several amino acid substitutions on specific positions responsible for a decreased risk of relapse were identified in HLA-Cw, but not in HLA-DPB1. These findings might be crucial to elucidating the mechanism of the decreased risk of relapse on the basis of HLA molecule. Donor selection made in consideration of these results might allow the separation of GVL from acute GVHD, especially in HLA-DPB1 mismatch combinations.

scholarly journals A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation

Blood ◽  
2008 ◽  
Vol 112 (8) ◽  
pp. 3036-3047 ◽  
Author(s):  
James L. Gajewski ◽  
Viviana V. Johnson ◽  
S. Gerald Sandler ◽  
Antoine Sayegh ◽  
Thomas R. Klumpp
Keyword(s):  
Progenitor Cell ◽  
Human Leukocyte ◽  
Transfusion Practice ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Leukocyte Antigens ◽  
Transfusion Requirements ◽  
Successful Transplantation ◽  
Compatible Blood ◽  
Patient Presentation

Abstract The increased use of hematopoietic progenitor cell (HPC) transplantation has implications and consequences for transfusion services: not only in hospitals where HPC transplantations are performed, but also in hospitals that do not perform HPC transplantations but manage patients before or after transplantation. Candidates for HPC transplantation have specific and specialized transfusion requirements before, during, and after transplantation that are necessary to avert the adverse consequences of alloimmunization to human leukocyte antigens, immunohematologic consequences of ABO-mismatched transplantations, or immunosuppression. Decisions concerning blood transfusions during any of these times may compromise the outcome of an otherwise successful transplantation. Years after an HPC transplantation, and even during clinical remission, recipients may continue to be immunosuppressed and may have critically important, special transfusion requirements. Without a thorough understanding of these special requirements, provision of compatible blood components may be delayed and often urgent transfusion needs prohibit appropriate consultation with the patient's transplantation specialist. To optimize the relevance of issues and communication between clinical hematologists, transplantation physicians, and transfusion medicine physicians, the data and opinions presented in this review are organized by sequence of patient presentation, namely, before, during, and after transplantation.

Prophylactic red blood cell exchange for ABO-mismatched hematopoietic progenitor cell transplants

Transfusion ◽  
2013 ◽  
Vol 54 (7) ◽  
pp. 1857-1863 ◽  
Author(s):  
Robyn Cunard ◽  
Isagani I. Marquez ◽  
Edward D. Ball ◽  
Connie L. Nelson ◽  
Sue Corringham ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Progenitor Cell ◽  
Hematopoietic Progenitor Cell ◽  
Hematopoietic Progenitor ◽  
Cell Transplants
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